CBC hospital survey not a balanced scorecard

The CBC has released a ranking of hospitals across Canada as part of an investigative report. While some VCH facilities ranked high (for example, Richmond Hospital scored a ‘B’), others were not seen by the CBC group in such a favorable light. Vancouver General Hospital, one of the country’s most respected and high-performing academic facilities, was rated as a ‘D’ despite performing well in a number of key quality and safety indicators.

We know through data and experience that VGH, as well as Richmond and Lions Gate Hospital (which the survey scored as a ‘C’), provide excellent care, are well regarded by peers and achieve high satisfaction rates among those who truly matter – the patients we all serve.

While we certainly face challenges in providing care and there are always areas for improvement, I am concerned that subjective surveys, such as this one, may lead people to think the quality and safety of care at their local hospital is unsafe. Such concerns are absolutely unfounded.

I want to reassure staff members and physicians throughout VCH that this media survey does not present a balanced picture of quality and safety at our hospitals.

About the CBC ranking
The data used to calculate these rankings came from a variety of sources, which were reviewed, prioritized and ranked by panel of experts selected by the national broadcaster.

The survey neglected to include the widely acknowledged and important Canadian Institute for Health Information (CIHI) measure of patient safety and quality of care — the hospital standardized mortality ratio (HSMR). The HSMR is calculated as a ratio of the actually number of deaths to the expected number of deaths among patients in hospital. VGH is well below the national average and yet this key statistic does not appear to have played a role in the hospital’s ranking.

The methods used in the survey also do not adjust for the difference in case mix (i.e. the type of patients we serve). Case mix is important because some cases – such as mental health and addiction patients – are more prone to readmission than other categories of patients.

Our impressive track record
Our most recent patient satisfaction survey showed that 93.5 per cent of patients who received care at VGH said the quality of their care and services was “excellent, very good, or good.” That number rose to 96.7 per cent for UBC Hospital patients, while almost 100 per cent of patients at both sites said they would recommend the hospitals to their family and friends based on the care they received.

Only a few months ago, reviewers from Accreditation Canada, an independent organization that sets standards for quality and safety in health care organizations across the country, conducted an intensive on-site survey at VGH and UBC Hospital. The surveyors determined that we met 98 per cent of the 2,300 safety and quality criteria to achieve one of the best results of any integrated health authority in Canada.

Our commitment to quality
VCH is committed to quality improvement and transparency, which is why we publicly post financial information and performance measures on our website, and share information with CIHI for continuous improvement. VCH has some of the lowest hospital-acquired infection rates in the country and is one of the few health authorities to share our performance through a public Health Care Report Card on our website.

Thanks to you
Our patients and their families can rest assured knowing that each and every day our staff, physicians and nurses – all of you – work hard to provide the best care possible. I hope that you will not lose sight of this fact in light of this questionable media survey.

Related links

We got a D? – Blog by Dr. Patrick O’Connor
Behind the CBC’s numbers – Mark Chase